Provider Demographics
NPI:1508757568
Name:GARCIA VAZQUEZ, CARLA M
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:M
Last Name:GARCIA VAZQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 311
Mailing Address - Street 2:
Mailing Address - City:NAGUABO
Mailing Address - State:PR
Mailing Address - Zip Code:00718-0311
Mailing Address - Country:US
Mailing Address - Phone:787-718-6615
Mailing Address - Fax:
Practice Address - Street 1:16 CALLE JOSE CELSO BARBOSA
Practice Address - Street 2:ESQ LUNA LOCAL 3
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771
Practice Address - Country:US
Practice Address - Phone:787-456-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000580224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant